May 31, 2022
By Sean Whooley
How Glytec is advancing insulin management in the hospital
After years of running a hospitalist group and mentoring hospitals on quality improvement, blood clot prevention and more, Dr. Jordan Messler found himself falling into a lot of work on diabetes.
Messler cut his teeth on quality improvement around diabetes, observing that inpatient glycemia impacts about 40%-50% of patients in the hospital. That work brought him to Glytec, where he now serves as chief medical officer.
“The work that I’ve done in quality improvement around glycemic control has been to help to standardize care,” Messler told Drug Delivery Business News. “We know what best practices are to manage diabetes in the hospital and, largely, that revolves around insulin.”
Waltham, Massachusetts-based Glyetc designed its eGlycemic Management System (eGMS) for managing insulin around the FDA-cleared Glucommander algorithm, which uses real-time and historical data to recommend insulin dosing by learning each patient’s insulin sensitivity and anticipating future needs, leading to a personalized treatment regime that can reduce hypoglycemia, hyperglycemia, lengths of stay, readmissions and cost of care.
Messler said insulin is one of the top three medications in the hospital that can cause adverse events in the management of high blood sugar with the risk of causing low blood sugar. To manage all that, Glytec’s software integrates with electronic medical records (EMRs), making it easier to safely manage insulin.
With Glucommander, nurses are informed of the hourly blood sugar checks and offered insulin dose recommendations without having to do the calculations on their own. Messler said physicians, including himself, can be guilty of leaving issues like diabetes and blood sugar lower on the list of concerns while caring for patients in the hospital, so having an option that eases that burden makes a massive difference.
“We’re using Glucommander to help safely manage [the patient] and to get the recommended doses,” Messler said. “If you’re not paying as close attention to blood sugar, insulin doses are being adjusted and really helping to manage blood sugar safely so patients can have safe hospital stays, shorter length of stays and avoid severe hypoglycemia as well as treat high blood sugar hyperglycemia.”
New partnerships lead to growth
Messler highlighted Glytec’s growth over the nearly four years he’s been with the company, pointing to funds raised — including $21 million brought in a little over a year ago — as he said employee headcount has increased by about 50%.
Part of that growth has been strategic partnerships, with perhaps the largest of those coming at the start of 2022, when Glytec entered into a digital health collaboration with Roche Diagnostics USA.
“Diagnostics play a critical role in helping people live longer and healthier lives and we are hopeful that this partnership with Glytec will bring an innovative glucose management tool to the point of care,” Roche Diagnostics SVP of Core Lab & Point of Care Brad Moore said when the companies announced their partnership. “Our goal is to drive better care for patients and there is a great need for a diagnostic ecosystem that combines accurate results, robust data, and digital capabilities to improve the standard of care.”
Glytec’s partnership combines its Glucommander software with Roche’s expertise in medical devices and IT solutions in an effort to address the challenges associated with inpatient blood sugar management at the hospital bedside. Glucommander will be the first software application available on Roche’s Cobas Pulse smart, next-generation hospital blood glucose system.
Roche designed Cobas Pulse to improve patient safety and care by empowering point-of-care clinicians to collect and take immediate action on glycemic management data. The combination of hardware and software brings together the immediacy of a bedside blood glucose test with Glytec’s insulin decision support on a single, handheld device to streamline workflows and save time. Cobas Pulse does not hold FDA clearance, but Messler emphasized that, once it is cleared, Glytec wants to be ready to work with it.
“The cognitive load reduction is the goal, with the workflow efficiencies to help nurses be able to do their care safely and easier,” Messler said. “This is a step that direction and it’s really exciting to work with a partner like Roche, someone that’s very important in the diabetes space as well as other areas around healthcare.
“I think it just validates our journey.”
Insulin management in hospitals picks up steam
A big step forward for the space as a whole came earlier this year when Dexcom announced that it received FDA breakthrough device designation for the use of its CGM in a hospital setting.
There had previously been a COVID-19-related FDA guidance allowing increased remote monitoring of hospital patients in order to limit contact with hospital staff including continuous glucose monitoring. Still, Dexcom’s breakthrough nod represented the acknowledgment of what could be a new way forward in hospital care.
Messler said that breakthrough designation represents an integral development for companies like Glytec, as the company wants to be ready for its algorithm and software to support CGM once the FDA eventually fully clears it for hospital use.
“A lot of institutions are starting to get familiarity with continuous parameters in the hospital and it really can be a game changer for patients, for frontline clinicians and for patients, not having to get all these fingersticks,” Messler said. “Clinicians now have more accurate, continuous data to help better manage patients. That’s exactly the space that we’re in, learning how to take this information and turn it into meaningful, safe insulin dose recommendations to help safely manage these patients.”
Messler said that an estimated 30% of hospitals have “no reasonable information” on glycemic management and up to 50% may have some basic data but very little beyond that. New Centers for Medicare and Medicaid Services clinical quality measures will be in place next year, which should drive change in rapid fashion, he said.
He called these steps forward an “intrinsic motivator” for increasing glycemic awareness in the hospital, with Glytec readying itself for whatever comes next.
“If you can’t measure something really well, you can’t change and can’t improve and you don’t know how to act on it,” Messler said. “Why would you implement solutions if you don’t know how well you’re doing? I think a big step forward in the future years for more hospitals and health systems is to have better awareness of what’s happening in the glycemic space, what are their metrics around low and high blood sugar and one of the game changers in that space is going to be new regulatory measures.”
This article originally appeared in Drug Delivery Business News.
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